Fibro Osseous Lesions

Fibro Osseous Lesions

Question. Enumerate firo­osseous lesions. Describe in detail monostotic fibrous dysplasia.

Answer. In fibrous dysplasia, normal bone is replaced by benign fibrous tissue showing varying amounts of mineralization.

“Impact of bone remodeling in fibro-osseous lesions”

fibro osseous lesions

Classification of Fibro-osseous Lesions

• Developmental:
  • Solitary bone cyst
  • Gigantiform cementoma
  • Cherubism
• Reactive/Reparative:
  • Aneurysmal bone cyst
  • Central giant cell granuloma
  • Garre’s osteomyelitis
  • Osseous dysplasia
    • Florid osseous dysplasia
    • Cemental osseous dysplasia
    • Focal osseous dysplasia or sclerosing osteomyelitis
  • Osseous keloid
  • Traumatic periostitis
• Neoplasms:
  • Benign cementoblastoma
  • Ossifying fibroma
    • Conventional
    • Juvenile trabecular
    • Juvenile psammomatoid
  • Osteoma
  • Osteoid osteoma
  • Osteoblastoma
• Endocrinal/Metabolic: Brown tumor of hyperparathyroidism
• Idiopathic:
  • Fibrous dysplasia
  • Paget’s disease.

“Risk factors for developing fibro-osseous lesions”

Monostotic Fibrous Dysplasia

ossifying fibroma

Monostotic fibrous dysplasia is a condition in which single bone is involved and is replaced by abnormal fibrous connective tissue which undergoes osseous metaplasia and the bone is transformed into dense lamellar bone.

Clinical Features Of Fibrous Dysplasia

• It involves only one bone and pigmented skin lesions are present.
• The sites affected are the maxilla, mandible, ribs, and femur.
• It occurs in children younger than 10 years and both the sexes are equally affected.

“Understanding periapical cemento-osseous dysplasia”

Oral Manifestations Of Fibrous Dysplasia

• Maxilla is more commonly affected than the mandible and most of the changes occur in the posterior region. The most common area involved is premolar area.
• There is a presence of unilateral facial swelling, which is slow-growing with intact overlying mucosa.
• Swelling is painless but a patient may feel discomfort.
• There is a presence of enlarging deformities of the alveolar process, mainly of the buccal and labial cortical plates.
• In mandible, there is a protrusion of the inferior border of the mandible.
  Teeth present in the affected area are malaligned and tipped or displaced.
• Supernumerary teeth are often impacted and affect the eruption of the teeth.

“Symptoms of fibro-osseous lesions in the jaw”

Histopathology Of Fibrous Dysplasia

• Lesion is essentially a fibrous bone made up of proliferating firoblasts in compact stroma of interlacing collagen fiers.
• Irregular trabeculae of bone are scattered throughout the lesion.
• Some of the trabeculae are C­shaped and described as Chinese character-shaped.
• There is permanent maturation arrest in woven bone stage.

“Emerging treatments for fibro-osseous lesions”

Treatment Of Fibrous Dysplasia

• Surgical removal of lesion
• Osseous countering is necessary for characterizing deformity for aesthetic or pre esthetic purposes.